IHI National Forum on Quality Improvement in Health Care The presenters have nothing to disclose Catalyzing Students and Trainees as Agents of Change Wednesday, December 13
Becka DeSmidt, Community Manager, IHI Open School James Moses, MD, MPH, Chief Quality Officer and Vice President of Quality and Safety at Boston Medical Center, Faculty Advisor, IHI Open School Kate Hilton, JD, MTS, Founding Director, ReThink Health, Faculty Advisor, IHI Open School Kristen Swain, RN, BSN, Project Manager, Lahey Clinic, Student, Suffolk University MBA Program Michael B. Holbrook, MBA, Student, Wright State University Boonshoft School of Medicine Nick Christian, MD, MBA, Resident, University of Texas at Austin Dell Medical School
Session Objectives Learn from young learners how to design and implement a people-driven, action-oriented campaign effort Explore ways to apply organizing skills to your own population health or improvement effort Learn how to connect with and engage students and trainees as leaders in your work
Agenda Background on the IHI Open School and the Change Agent Network (I-CAN) Key skills in quality improvement and community organizing to leverage to effect change, illustrated by student leaders Questions, Wrap up & Next steps
Overview of the IHI Open School
IHI Open School Mission Advance health care improvement and patient safety competencies in the next generation of health professionals worldwide.
IHI Open School Strategy
IHI Open School by the Numbers 32 online courses More than 3 million courses completed More than 95,000 learners have earned the Basic Certificate Quality & Safety 1,500 universities and organizations use the courses for training or curriculum
IHI Open School by the Numbers 500,000+ students and residents registered Over 875 Chapters in 85 countries Pharmacy Other Nursing Physician Assistant Occupational & Physical Therapy Medicine Social Work Allied Health Professions Law Business Dentistry Engineerin g Health Science & Administrat ion
IHI Open School Change Agent Network (I-CAN) is our community of change agents who are actively applying the skills they re learning in quality improvement, patient safety, community organizing, leadership, and more to improve health and health care and lead change on their campuses, in clinical settings, and in their communities. 10
Leadership & Community Organizing Training 10-week semi-synchronous online course: 30-45 minutes of video lectures 60-minute coaching calls 1-3 hours application Organizing & Leadership Training Learners apply leadership practices in field-based projects to improve health Improvement Science Change Subject Matter Knowledge www.ihi.org/lead
Organizing Theory of Change Power: Building a community around that leadership to create power Change: Using this power to address the challenge the constituency is called to face People: Recruiting and developing leadership people acting together to change the status quo
What is Leadership? Leadership is accepting responsibility for enabling others to achieve shared purpose in the face of uncertainty. A practice, not a position Authority is earned, not bestowed Focus is on developing others, not just yourself
Building a Movement Engaging 35K in Actions to Improve Health Between September 2014 and December 2015: Lead: >400 learners took the course and led a local health improvement project Learn: >3,000 individuals mobilized by project teams on campuses and in communities Pledge: >35,000 individuals made commitments to improve population health
Impact of the Program Over 1,500 students, residents, faculty, and professionals have engaged with the course Learners who complete the program have higher confidence in their ability to leverage community organizing and leadership skills in their day-to-day work
Key Skills to Effect Change
The Power of Quality Improvement and Community Organizing People: Recruiting and developing leaders Power: Building a community around our leadership to create power Change: Using our collective power to create change
Key Skills to Effect Change 1. Know why you care 2. Set a measurable aim 3. Start small & scale up 4. Take an asset-based approach 5. Build relationships and gain commitment 6. Distribute leadership 7. Develop a learning community * Steps developed with Alexandra Nicholas (Ko Awatea), Kate Hilton (ReThink Health), Jackie Lynton (NHS Change Day), and Jessica Perlo (IHI Open School)
Kristen Swain, RN BSN Project Manager, Performance Improvement Operations
Public narrative
What is Public Narrative? A leadership skill to motivate others to join us in action
Elements of Public Narrative Why me? Why now? CALL TO ACTION Why us? WHY US?
Start small and scale up
Pair-Sharing 2 Minutes: Turn to a partner at your table and share a time when you ve seen the value of testing a change on a small scale before implementing it widely
"If you maintain a teachable attitude as you approach the process and try to learn ANYTHING you can about what you could do differently, you will improve yourself. When a person has the right mindset, every obstacle introduces him to himself." -Failing Forward by John C. Maxwell Fail forward
Failing Forward 27 Credit: SCALE 1.0, Institute for Healthcare Improvement
Michael Holbrook Student, Wright State University, Boonshoft School of Medicine & Nick Christian Resident, University of Texas at Austin Dell Medical School
= COAT Take an Asset-Based Approach
Why Map Stakeholders and Assets?
Organizing = People, Power & Change (1) Who are our People? (2) What Change do they want? (3) How can they get the Power they need to achieve that change?
Strategy is turning the ASSETS we have into the POWER we need to get the CHANGE we want
Why Map Actors & Assets? Recognize people as our greatest asset Reframe relationship among traditionally-siloed stakeholders as partners in health equity Build power with instead of doing to or for Develop our strategy from within Promote reciprocity, mutual respect & trust Generate collective power to co-produce equity
Silently Reflect 2 minutes: How could mapping stakeholders and assets advance an element of your work?
SOC Event Naloxone Training Session Post Event Networking Deterra Medication Disposal System Grant One to One Conversation Gail Dafler, Prevention Branch, COAT One to One Conversation Caleb Tang, Cedarville University School of Pharmacy Student 50 First Year Pharmacy Students Relational Strategies to Gain Commitments
One-to-One Meetings 1. Selection & attention 2. Purpose 3. Exploration 4. Exchange 5. Commitment 38
Be Shepherds 39 Slide from Presentation to First Year Pharmacy Students Values-Based Commitment
Why will this work? Why will they care? Meaningful project Easy to participate Autonomy given Student s strengths Understanding Interests
1. What change do we want? (What is our interest?) INTERESTS Commitment INTERESTS 3. What do they want? Power with: What is their interest? Power over: What is their vulnerability? OURSELVES OUR PEOPLE ASSETS ASSETS 4. What assets do we have that they want? Commitment 2. Who has the assets to create that change?
What is Power? The ability to achieve purpose POWER WITH POWER OVER
Distributing Leadership
Distributed Leadership
Distributed Leadership Builds an equal status contract around a shared purpose Is commitment-driven, not compliance-based Cultivating people s agency to act increases joy and improves health Builds capacity that serves as an ongoing asset for addressing other problems 46
Put students in rotations and experiences where they can engage their community and build meaningful relationships.
Next Steps & Questions
Volunteers to Share: How are you currently engaging students and residents in efforts to improve health, and how could you offer them a greater opportunity to lead?
Show of hands: How many of you have worked with an IHI Open School Chapter?
www.ihi.org/openschool
Connect with a Local Chapter with the Click of a Button
Take a Deeper Dive into the Concepts we Shared Today: The next offering of the 10-week online course begins in February Contact info@ihi.org to learn more
Did We Achieve Our Objectives? After this session, can you: Describe community organizing approaches to improving the health of your local community? Develop intervention ideas for improving the health of vulnerable populations in your local setting? Identify local IHI Open School learners to engage in your organization s initiatives? Any questions?
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